JAMA Commentaries Discuss Role of Costs in Overhauling U.S. Health System, Implementing Effective EHR Systems

• "The Cost-Coverage Trade Off: 'It's Health Care Costs, Stupid,'" Journal of the American Medical Association: In the JAMA commentary, Ezekiel Emanuel of NIH writes that efforts to overhaul the U.S. health care system should focus on costs rather than on the uninsured and lack of coverage. According to Emanuel, "any attempt at universal coverage will be transient" if costs are not controlled. He also discusses how cost control and universal coverage must occur at the same time and how presidential candidates' health care plans must include a financing structure and incentives for controlling costs to be effective (Emanuel, JAMA, 2/27).
  
  
• "Health Care as if Health Mattered," JAMA: The JAMA commentary by Thomas Frieden and Farzad Mostashari of New York City's Department of Health and Mental Hygiene discuss three changes that are needed to overhaul U.S. health care: payment that offers significant rewards for disease prevention and effective chronic disease management; an information system focused on prevention; and changes in care management and practice workflows. According to the authors, well-designed and effectively implemented electronic health record systems are an integral component to change payment structures and improve health care system performance, but prevention "must be integral" to EHR systems to improve health outcomes. Frieden and Mostashari also discuss key features of effective EHRs (Frieden/Mostashari, JAMA, 2/27).